This is an audio transcript of The Morning Brief podcast episode: Selling Sleep Part 1: India’s growing insomnia is worth billions of dollars

BG Sound 0:01
This is the morning brief from the economic times.

Anirban Chowdhury 0:14
I am lying on my bed, catching up on the latest episode of Rings of Power.

BG Sound 0:19
My brother gave his life hunting the enemy.

Anirban Chowdhury 0:25
The episode ends, it's 3am. I tried to sleep, but can't. The sounds and sights that were on my phone screen are now playing inside my head. Thoughts of work, of finances of family of tomorrow jostle for space. It's a struggle between a tired body and a restless mind. I faced sleep issues for years, and I've realized that I'm part of a very large and constantly ominously growing sleepless crowd. India is said to be the second most sleep deprived country in the world after Japan. According to a report by Fitbit, our quality of sleep is far below the global average. Senior citizens are worse off, and the most disturbing bit. Indian children are among the most sleep deprived in the world. A study by local circles found that one out of every four respondents is getting less than four hours of uninterrupted sleep now, the number of drugs to treat sleep disorders is growing. But whenever there is a problem, there are startups and solutions. Sleep sellers are on the rise. The Indian sleep product Federation estimates that 40 new mattress makers open shop in India in the last two years. Sleep trackers are on every phone and smartwatch. And of course, sleep and meditation apps are filling your ears with bedtime stories in the voices of Bollywood celebrities and white noise to lull you to sleep. And then of course, there are doctors, consultants and sleep coaches. The global sleep economy is worth more than $450 billion and will be about 600 billion in two years. In this two part episode, we try to look at the problem and the businesses rapidly growing around it. It's the ninth of September, I'm your host Anirban Chowdhury. And you're listening to selling sleep on the morning brief.

BG Sound 2:34
Because of lack of sleep, I've always struggled with insomnia.

BG Sound 2:39
There was a lot of fluctuation in my energy level.

BG Sound 2:41
Every morning when I would wake up, it would seem I was hit by a truck or a train.

BG Sound 2:47
I end up snapping at people even when I don't mean to.

BG Sound 2:50
I always used to feel low

BG Sound 2:52
Cranky I'm able to focus bloated and tired.

BG Sound 2:56
And the whole day I would walk around like a zombie couldn't concentrate couldnt focus, low energy, sporadic hunger pangs.

BG Sound 3:06
Sometimes I eat too much sometimes I don't eat for days, inability to focus on work,

BG Sound 3:12
and, you know, often carelessness in my decision making

BG Sound 3:16
when I got myself checked and I was told I have something called sleep apnea.

Anirban Chowdhury 3:24
To make sense of the problem, I spoke to psychiatrist and sleep expert, Dr. Satish Ramaiah, co-founder of People Tree Maarga super speciality psychiatric hospital in Bengaluru. Dr. Amaya, and a very warm welcome to the Morning Brief.

Dr. Satish Ramaiah 3:42
Good morning Anirban. Thank you for having me.

Anirban Chowdhury 3:44
So we are talking about sleep, which seems to be getting you know, more and more elusive for Indians. So I wanted to start by asking you whether sleep problems for Indians have become worse in the last two years. And has the pandemic aggravated those problems?

Dr. Satish Ramaiah 4:02
You're absolutely right in the last couple of years, the pandemic coming in and you know, completely disrupting our whole social fabric, you know, the emotional fabric and all that it is it has definitely had a significant impact on our sleep pattern as well. And particularly in India, with all the other challenges people had to face during the pandemic health and all the economic issues and all that it certainly had led to significant sleep problems. So it's not just about people going through insomnia, it's also the causes of insomnia have been much more complex because of all the illness and other issues and the consequences of sleep and the way it's been impacting people has also been a multifocal.

Anirban Chowdhury 4:40
Dr. Ramaiah what are some of the gravest health issues resulting from lack of sleep?

Dr. Satish Ramaiah 4:45
So first of all, to begin with the physical health problem, you know, it can actually worsen the any pre existing medical condition you may have, and it's an independent risk factor for cardiovascular health. You know, people not having any cardiac cardiac health issues after going through weeks and months of sleep difficulties can end up having cardiac health problems. Metabolic Syndrome is another cause, you know, consequence of sleep problems like diabetes, hypertension, glucose intolerance, weight gain can happen, it weakens our immune system. It can result in significant cognitive issues, that people having problems remembering things forgetfulness, attention, concentration, it affects the mental health, as we know, as a consequence, not as a cause people having anxiety, depression and all that. So absolutely, you know, it definitely has resulted in significant consequences.

Anirban Chowdhury 5:34
Okay. I'm sort of personally invested in this interview, you know, having faced sleep issues myself for the last many years with very serious repercussions. So, I wanted to ask you, Dr. Ramaiah, is the problem more complex in India than elsewhere in the world? Also, do you get higher number of people and more varied age groups coming to you complaining of lack of sleep now than before?

Dr Satish Ramaiah 6:03
Certainly the Indian sleep problems certainly ranks for amongst the top five or six really, because the the all the other complex problems no Indian population has been facing, you know, there's in because India, India is growing, right? Indian economy is growing. So people are constantly working hard. There's a little bit of rat race happening not just in the people in the working age population. But we also see that in the in students, particularly the pandemic season with all the online classes and everything, and the competitive attitude of all the students and the parents has led to significant sleep disruption as well, in erratic pattern, the lifestyle, the behavior, the emotional issues involved mental stress that contributes to sleep problem. So certainly it had a significant, much more complex problem in Indian population. And as clinical practitioners, we do see a significant increase in our clinics, you know, people presenting with sleep problems for the last couple of years, ranging from young children to working age population,

Anirban Chowdhury 7:02
You said Little children, I mean, is that something new? And that's extremely disturbing? I think it is. It is actually in the last couple of years, and I personally, had seen a lot of young children presenting with significant sleep disruption, which you know, young children, particularly, you know, the normal physiologies young children should be ideally sleeping well, when there is darkness, that's when there is this melatonin secretion happening and also the growth hormone surge happens. So when it comes to sleep, there is a specific pattern that is followed. So what is biological clock does this you know, look at the beauty of the nature, what it does is it through its mechanism, it releases a hormone called melatonin. But most most of people would have heard about this melatonin, it's a sleep inducing hormone. It's a natural hormone, it's there, through our pineal gland, it's released and it is released only when there is darkness. So when sunset happens, the melatonin slowly starts secreting in the brain. And that slowly induces you into sleep. However, given the pandemic situation, given the disruption that brought in for the whole lifestyle and sleep pattern, obviously, biologically also had significant impact on children's sleep patterns and the mental health, the cognitive issues leading to the academic performance, and so on.

Anirban Chowdhury 8:14
I wanted to ask you are more and more people from corporate India coming to you would sleep problems, especially after the pandemic, you know, CEO CXOs. and the like?

Dr. Satish Ramaiah 8:23
Absolutely. You know, particularly, in the last couple of years, since I was also associated with the company, we were, you know, developing a lot of sleep solutions. And that's when I came across a significant number of top management of companies, CEOs having significant sleep issues. So the last couple of years, it certainly has increased multiple. And I can give one such example as a company CEO, I obviously don't want to name him. So he is from Mumbai. And through some contact, he consulted me and typically he's been finding it very hard to get into sleep. And that led to a lot of rumination. You know, he's been getting ruminating thoughts about the work that what what he did the previous day, the lined up work for the following day, and then slowly took away sleep and the falling asleep. Timing, you know, got extended and extended. Eventually what happened was you started getting into day time anxiety about sleep. So this is the we call it anticipatory anxiety basically he started to worry about sleep, we started to worry that will I get sleep tonight a lot. If I don't, how will I manage the night? And how will I manage the following day? You know, that particular anxiety itself actually started breaking down his sleep further. So the more you worry, the less you sleep, and the less you sleep, the more you worry, maybe kind of get trapped in that little cycle, and it kind of make things worse. So this gentleman had one significant problem. I've started affecting his mental state, his performance at work, I think this team got concerned and they actually advised him to consult a doctor and eventually we had discussed several treatment strategies and all that I think he started to do to do well Oh, yeah, definitely there's been significant increase in sleep problems across the board, including top management and business people and all that.

Anirban Chowdhury 10:09
But awareness of sleep and its importance is really low in India, right? Does that ignorance shock you sometimes, especially from your more educated well to do well heeled clients?

Dr. Satish Ramaiah 10:21
Yeah, no this particular description of what you just said, you know, this is shopping ignorance, I almost see it every other day, actually, it's quite a common phenomena, because, especially with the learned people highly educated into big positions in big companies, you know, we see them, you know, not following a good sleep hygiene at all, many a times, they know the sleeping pattern would be like that they go to bed at 4am in the morning and try to wake up attend couple of meetings and go back to sleep. And you know, total disruption of sleep had resulted in a significant mental health and cognitive effects, including the lifestyle recently, one top management guy was, you know, I think he he always wanted to prove his point to me that look, doctor doesn't matter when I sleep, and I can't afford to sleep, like you advise a typical nighttime sleep, I can't afford to do that, you know, time is money for me. So I know, I felt really sorry for him, he is overweight, and he's already having metabolic issues, and is more concerned about sleep. Yeah, I do see that, you know, quite quite often when people are very ignorant, or because of various other reasons, they can't commit to work on a good sleep.

Anirban Chowdhury 11:28
Okay, coming to the business part of it, you know, there is a whole ecosystem that is sprouting around this problem of sleep, you know, mattress companies are becoming more aware of the problem. You know, they're trying to sell sleep rather than bedware you said you advise some of the companies. Can you give us some examples of how this works?

Dr. Satish Ramaiah 11:51
Yeah, absolutely. I think as people are becoming more aware about the sleep problem and its consequences, in one of the papers, I was reading, the estimated economic burden for the world, because of sleep problems alone is about 300 billion to 500 billion.

Anirban Chowdhury 12:06
Wow, interesting.

Dr. Satish Ramaiah 12:07
That's a staggering number.

Anirban Chowdhury 12:09
Yeah,

Dr Satish Ramaiah 12:09
yeah, it's a staggering numbers. I think the corporate world has realized that I think that a lot of people, you know, kind of coming together to find innovative sleep solutions, like you mentioned, mattress companies are not just they're not just looking at, you know, selling the mattress, they're looking at, you know, providing a comprehensive sleep solution. So yes, I'm on the advisory board of one of the mattress company, Duraflex, wherein they're bringing up this initiative called REM 42, through which they were what they want to do is, you know, provide a comprehensive Sleep Solution, looking at how we can make people sleep better.

Anirban Chowdhury 12:43
Right. That's interesting. I mean, is this a global trend, these companies getting into the whole, you know, deeper into this whole problem and trying to get into this consultative relationship with their customers?

Dr Satish Ramaiah 12:56
I think it is in in the US as well. I think several companies have come forward, which which I think is a good thing for the society because you know, it also enhances people's awareness. You know, I think all we knew about sleep was yes you need a good mattress and it's you know, if we just go to bed and sleep, but how about now we know that you know, there's so so much of complex phenomena involved in our you know getting good night's sleep. So these companies are investing lot of money into understanding the sleep science, the physiological aspects, the psychological aspects, and the social aspects personality aspects and see how we can holistically get people to sleep better. Yeah, it is a global threat.

Anirban Chowdhury 13:36
Mattress pillows and other bedware accounted for the largest chunk of the sleep economy. The Indian market for mattresses is around 15,000 crore rupees, and is growing at a rate of 10% every year. bigger brands occupy more than a third of the market while the rest of the space is filled with unorganized players. The brand will soon have a 40% share of the market, which means that Indians are spending more on their bedding. New products are flooding the market. They're being rolled into thin cylinders packed and transported across the length and breadth of the country from Lakshadeep to Leh from Silchar to Saurashtra. Investors quite like this space in companies and startups are raising money. 50 year old Duraflex raised $60 million last year from Norwest Venture Partners. Startups wake fit, sleepy cat and sleep company raised a combined total of about 45 million in the same year in different stages of funding. The revenues are growing too. In fact, wake fit expects to break even in the year 2024. Now wait fit. A Sequoia Capital backed company has been somewhat of a disruptor in the space, selling a feel and buy items such as mattresses online and laying down a culture of sleeping at work with something called a Right to nap and sleep internships. So obviously my first question to our second guest, Wakefit's co founder Chaitanya Ramalingegowda is this? Chaitanya, What is your sleep cycle? Like how disciplined Are you?

Chaitanya Ramalingegowda 15:17
Actually, as a founder, I have to make a confession. My, my first startup failed after a year, about 11 years ago, second startup failed in three years. And then my third startup was Wakefit. So you can imagine that my sleep quality was not really so good. In those years, a lot of stress, company was not doing well, and so on and so forth. But now, the last three years or four years as my own knowledge, my own understanding of the science has gotten better and better, I have tried to bring in a lot of discipline, I'm happy to report that I get about seven hours of sleep, I'm able to wake up a little fresh, obviously, we go through periods of stress, and so forth, during the pandemic, when company had to look at cash flows, or when fundraising happening and so forth. But by and large, my life has gotten much better over the last three, four years.

Anirban Chowdhury 16:08
Wakefit's creation, however, had nothing to do with sleep problems. The idea actually took seed when the company's co founder, Ankit Garg was planning to get married,

Chaitanya Ramalingegowda 16:18
when my co founder Ankit was getting married, about seven years ago, he was trying to set up his home. So he went to the market, trying to buy furniture, buy a mattress, buy a bed for himself, because he was setting up the home for his wedding that was coming up in the next few days. But then, when he saw the prices of these good foam mattresses in the market, there was a huge delta, which means there was nearly 40 to 50% delta, what the customers were paying, as opposed to what it actually costs to produce a good quality mattress. So when he came to me, and we had just become friends back then, and my first instinct as an MBA was that, hey, maybe these companies are very, very profitable, because the delta is so high 40 - 50%. And I was in for a big surprise. And that surprise was these companies, in fact, were not so profitable. They were at an EBITDA of somewhere around 10 - 12%. So where is that money going? And when we dug deeper, the answer was that all of that money was going into channel margins, which means between the brand and the customer, there were three or four levels of middlemen,

Anirban Chowdhury 17:31
so Ankit and Chaitanya, started wakefit. They avoided middlemen and the costs that came with them, and built their businesses on the direct to customer model. Most of their sales are online. But when Chaitanya and Ankit started wakefit in 2016, they soon found out that Indians did not know much, or care much about sleeping well,

Chaitanya Ramalingegowda 17:53
The awareness about sleep in India has been extremely low, a large, large part of the country still sleeps on cotton ghadda that you purchase from a local store. They don't understand spinal alignment. They don't understand body temperature and its impact on sleep. But the pandemic sort of brought all of these things into focus, because suddenly, you were thrust into a situation where you're spending 24 hours a day at your home, the boundaries between work, and personal life were blurred. People realized the importance of sleep and the overall space. That's because they realized that in this situation where anxiety is playing such a big role when youre worried about the pandemic, sleep was the biggest respite. And that brought in lot of awareness around books around podcasts around articles, where people started talking about how sleep could actually improve immunity, and does in fact, be a protection against the pandemic

Anirban Chowdhury 18:53
Chaitanya and Ankit had to do tons of research on how India slept, there was very little data available.

Chaitanya Ramalingegowda 19:00
When we tried to look up on the internet or look for any studies, we found that a multinational company had last done a sleep data analysis of Indians some five, six years back when we evaluated this phase in 2016. So there was no India based study, there was no frequency, and we didn't understand how Indians slept. So what we did as a company was to speak to customers after the product was shipped to them. And so we would ask what they were concerned about in the product, whatever concerned about the packaging, how was the first seven days experience? How was the first 14 days experience? Are they sleeping better? Are they feeling rested? And then the genesis of great Indian sleep scorecard was also the same saying that why should an MNC doing a study once in 10 years be the basis for our understanding of Indians sleep habits, we should be running this every single year and we should do lakhs and lakhs of surveys and interviews to understand their sleeping patterns.

Anirban Chowdhury 19:59
The great Indian sleep scorecard is data on India sleep patterns that wakefit has been collating for the last five years. And the trends are quite scary.

Chaitanya Ramalingegowda 20:09
Every year, the number of people who consider themselves insomniacs has gone up. It is currently somewhere around 20 to 22%, which means one in five Indians have sleep problem. Sleep is the first casualty, no matter what else is happening in your life, and people are ignoring it left, right and center. Nobody talks about it, nobody remembers it. So that's the role that we are trying to fill, where we are saying you cannot ignore this. It has long term consequences. It's people used to say sitting is the new smoking, we are saying insomnia is the new smoking. So we realized early on that this is an iterative process, where the global best practices from the sleep labs, from the universities, from the researchers that are doing cutting edge work, we need to take the best practices, but then we need to adapt it to how Indians prefer and how Indian climate conditions work.

Anirban Chowdhury 21:09
Is there a type of mattress broadly speaking for India, I mean, you must have done your global research as well. So there must be a kind of mattress that say Germans use, or a kind of mattress that most Americans use, where does India feature in that sort of range?

Chaitanya Ramalingegowda 21:27
Now, it's a very interesting question. You ask Anirban, you're absolutely right, that demographics and historic preferences play a role in what kind of sleeping surface that country likes. And you're absolutely right in also guessing that each of these different countries use don't use the same type of mattress, or same type of firmness. So Germans prefer historically, a very, very hard mattress. Similarly, the US consumers prefer a much softer mattress, which almost sinks in, that's why you you take Indians or you take Europeans, and when they go to the US, they actually feel uncomfortable in the hotels there because it sinks too much. If you take these two as the extremes, where US prefers really, really soft, and that is a zero. And you take Germany on the other end of the spectrum, where they prefer really firm mattresses, that's number 10. Zero to 10 scale. If you take this as a hypothetical scale, India would feature somewhere around six to seven.

Anirban Chowdhury 22:25
And then there are finer nuanced differences and preferences between different demographics, different levels of temperatures and cities, and of course, economic groups. There are at least 20 kinds of mattresses in the market to suit your body type and temperament. There's memory foam mattress, orthopedic mattress, gel, latex, inner spring, hybrid pillow top poly foam, and air mattresses. And what's more, just like your mobile phone, mattresses can have upgrades too and those upgrades come after tons of research.

Chaitanya Ramalingegowda 23:01
Flagship orthopedic memory foam mattress is today in its 18th or 19th iteration in its seven year history.

Anirban Chowdhury 23:09
Wow.

Chaitanya Ramalingegowda 23:10
That means and yeah, that's it's fascinating, right? Just like you have a mobile upgrade operating system every single

Anirban Chowdhury 23:16
exactly here. Yeah, exactly.

Chaitanya Ramalingegowda 23:18
Every few months, why should you be stuck on an old technology or a technology that is there 10 years ago. So that's why we collaborated with National Institute of Mental Health and neurosciences NIMHANS in Bangalore, but they have a sleep laboratory. And the team there is able to share their findings on what patterns of sleeplessness they're seeing, what is the kind of materials that they're sleeping on? What are the anxieties that are keeping people up at night, so they are able to share their insights. So depending on all of these angles, which is orthopedics, wellness, movement, versus sedentary life, neurosciences, all of these inputs become a part of our product creation and product iteration journey.

Anirban Chowdhury 24:02
And you tried you your effort is for your employees to imbibe the same kind of culture because, I mean, your work policies are very interesting. You have a right to nap for your employees. You have a sleep internship, which became quite famous in, in social media, but tons of stories also why don't you talk to us a little bit about that.

Chaitanya Ramalingegowda 24:21
So the right to nap policy came as an idea after the workforce was coming back to Office slowly, starting with one day a week starting with two days a week. And then slowly impacting increasing it to three, four days a week, we realize that if we are a company that believes in making sleep accessible to as many people as possible, by making our products affordable. That's not the only way that we can live that vision. So we said one way to live that vision is to enable our employees to take a nap, at their desk, at their workplace, in the sleep room wherever they wanted, every single day. So our HR actually has blocked out half an hour every single day on every single employees calendar. And nobody can book any meeting during that time. And like you said sleep internship was also in a step in the same direction, which he started three years ago, where we said, we should not be looking down upon people who value their sleep above everything. So we every year, we chose people from across the country who would be our sleep interns, and we gave them one lakh rupees for the sleep internship, each of the selected interns, so we said we should celebrate these people who love their sleep.

Anirban Chowdhury 25:34
In the course of the interview, Dr. Ramaiah told me that inadequate sleep is actually a two decade old problem in India. It is only aggravated in the last two years in the form of what is now widely known as Corona Somia. The problem is real big and complex.

Dr. Satish Ramaiah 25:54
Sleep is extremely complex psychophysiological system. For a better night's sleep, when we need that peace of mind, that psychological calmness, the ability to deal with your ruminating thoughts, your physiological activities, like if you're suffering from any underlying medical conditions, your food habits, your behavior, if you're addicted to some kind of drinking, smoking and any sort of issue. So all those things can impact your sleep, no simple few sleep hygiene techniques to take a long way. First thing is go to bed at the same time, wake up at the same time as much as possible, including the weekends. Some regular exercise may not just keep an eye on your weight and what you eat the food habits and all that make sure that you eat a little early in the netbotz at least one and a half, two hours of gap between your last meal and sleep time. And sometimes like I said earlier, it could be simple environmental issue, you need to take care of the right noise levels, temperature, that type of mattress, you sleep in and all those things should be taken care of. And lastly, the biological clock. Let's you know give respect to the clock we have in our brain that the nature takes its natural course of helping us to have a better rhythm and keep your gadgets away. That's the last thing I would like to mention when you're ready for sleep.

Anirban Chowdhury 27:08
And the first step to solving the problem is knowing the problem. That's all for today. You were listening to selling sleep on the morning brief. In part two of the episode which drops on Tuesday, we tune into the world of sleep trackers meditation and calming apps. Look at the deep connect between mental health problems and sleep disorder and talk to a former Goldman Sachs Biggie who has created an app to deal with both issues. We hope you liked this episode. 

It was produced by Vinay Joshi from the economic times sound editor Indranil Bhattacharjee from et additional research threa Agarwal, executive producers and Anupria Bahadur and Arijit Barman from et. do like share and subscribe. Tune into et play our platform for all things audio. This is your host Anirban Chowdhury. Wishing you a good day and weekend. If you're listening to this at night, sleep well. all clips used in this episode belong to their respective owners. Credits are given in the description

Transcribed by https://otter.ai

This transcript has been automatically generated. If by any chance there is an error please send the details for a correction to: themorningbrief@timesgroup.com We will do our best to make the amendment as soon as possible.